Nevada psychiatric hospital accused of patient dumping

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SACRAMENTO, Calif. (AP) — Nevada’s primary state psychiatric hospital has transported more than 1,500 mentally ill patients to cities across the nation by Greyhound bus over the last five years, according to a published story.

As Nevada has slashed funding for mental health services, the number of such patients being bused out of Rawson-Neal Psychiatric Hospital in Las Vegas climbed 66 percent from 2009 to 2012, The Sacramento Bee reported Sunday (http://bit.ly/15cz8Bn ).

Last year, Rawson-Neal bused out patients at a pace of over one per day, shipping nearly 400 patients to a total of 176 cities and 45 states across the country, according to a Bee review of bus receipts kept by Nevada’s mental health division.

The issue has been under scrutiny since February when one Rawson-Neal patient turned up suicidal and confused at a homeless complex in Sacramento, where he knew no one and had never been before.

DJ Jaffe, executive director of the nonprofit think tank Mental Illness Policy Org., said his group often hears anecdotally about patients being “dumped” from one county to another.

“Discharging severely mentally ill patients inappropriately is policy in this country,” Jaffee told the Bee. “But getting rid of them altogether by busing them out of state is, I think, rare. I am shocked by these figures. It seems to be almost routine in Nevada.”

Mike Willden, director of the Nevada Department of Health and Human Services, doesn’t dispute The Bee’s figure that more than 1,500 Rawson-Neal patients have been bused out of state since 2008.

But he does not think the number is excessively high considering Las Vegas is an international attraction that draws nearly 40 million visitors a year, he said. As a result, he said, it will deal with more patients with psychiatric episodes.

“I categorically deny that Rawson-Neal hospital or the state of Nevada is patient dumping and I’m offended by that label,” Willden told The Associated Press on Sunday. “We’re helping and assisting people to get back to their state or county of residence.”

Under a 20-year policy, the department only arranges to discharge and pay for a patient’s out-of-state transportation when the patient has been stabilized and contact has been made with a friend, family member or treatment program to receive that patient, Willden said.

The Rawson-Neal patient who turned up disoriented after being bused to Sacramento in February represents a rare violation of the policy, Willden said. His agency has been reviewing cases since then and has found no pattern of inappropriate discharges, he added.

“In the vast majority of transports we’ve done the right thing,” Willden said. “In many of these cases, they (patients) expressly want to go back to their home where they came from. It’s the humane thing to do. Why keep someone in Las Vegas when they don’t want to be there?”

Officials in several of California’s largest counties said they rarely, if ever, bus patients out of state.

“We don’t do it, we never will do it, and we haven’t done it in recent memory, meaning at least 20 years,” San Bernardino County spokesman David Wert told The Bee.

Los Angeles County officials said they have not bused a single patient out of state during the past year, and when they have done so in the past they have supplied chaperones. The county has received 213 people from the Nevada hospital in the last five years, more than any place in the country.

None of the 10 state mental health agencies contacted by The Bee said that placing a psychiatric patient on a bus without support would be permissible. The agencies said they rarely bus patients and that Nevada’s practices seem out of step with the standard of care.

“Putting someone whose mental illness makes them unable to care for themselves alone on a bus for a long period of time could be absolutely disastrous,” said Dorian Kittrell, executive director of the Sacramento County Mental Health Treatment Center.

Greyhound spokesman Timothy Stokes said he was unaware of any serious incidents involving mentally ill patients from Nevada.

Willden noted Rawson-Neal is an accredited hospital. “You can’t be an accredited hospital and run a sloppy ship,” he said.